Outpatient Productivity

[wanderlustpt]

Hi everyone,

I am curious to learn how productivity standards are measured across the country and across different outpatient settings. I'm wondering a few things:
1. How many patients are you expected to treat per week (or, how else is your productivity defined)?
2. How many patients do you actually see per week?
3. What type of setting do you practice in?
4. What location do you currently practice in?

Here are my answers:
1. Expectation is 60 patients per 40 hour week. There is a a financial incentive if you exceed this number.
2. 55 - 68 patients per week
3. Private practice, outpatient, orthopedic
4. Massachusetts

Thanks in advanced!

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[starrsgirl]

When you say 60 patients, are those appointment blocks or literally 60 different patients? Is a patient coming in 3x week still "1 patient"? How long are scheduled appointments? Interested to hear more about this.

 

[wanderlustpt]

When you say 60 patients, are those appointment blocks or literally 60 different patients? Is a patient coming in 3x week still "1 patient"? How long are scheduled appointments? Interested to hear more about this.

Great question - I should have clarified. By 60 patients per week I mean 60 visits per week. This is the expectation for full time therapists. Patients usually are seen 2-3xs per week and that counts as 2-3 visits. It is expected that 4 codes are billed for every non-medicare patient. Scheduled appointments are 1 hour which means that patients generally receive a unit of manual therapy when applicable and go through most of their therex/theract/neuro routines in the clinic under the supervision of their therapist. Patients are scheduled on the 1/2 hour so there is overlap. If the therapist has a patient that requires a lot of extra attention or hands-on time they're allowed to schedule them 1 on 1 exclusively as long as they're meeting their quota. Initial evaluations are 60 minutes.

From what I understand this is relatively standard of private practices. But I only have a limited amount of insight from local therapists. Most don't like revealing their productivity measures, incentives, etc. so I don't push the discussion.

It seems like a lot of hospital-based OP settings schedule on the 1/2 hour and spend 30 minutes 1-on-1 with their patients. This would allow them to bill 2-3 codes per patient vs. 4-5 codes in a 1 hour timeframe. And I am guessing 2-3 codes per patient is not a problem because hospital based OP clinics are much less dependent on insurance reimbursement for their company's survival.

Just looking for some outside perspective.

 

[jblil]

It is expected that 4 codes are billed for every non-medicare patient.

If I understand correctly - the clinic expects you to bill 4 codes for a 30-min treatment?

 

[Sheldon]

Here's my situation:

1) No expected minimum or maximum BUT...
A) 11 patients/day w/ avg. billing/patient of $220 = $200 bonus
B) 13 patients/day w/ avg. billing/patient of $215 = $300 bonus
C) 14 patients/day w/ avg. billing/patient of $212 = $400 bonus
D) 15 patients/day w/ avg. billing/patient of $210 = $500 bonus
2) I avg. about 50 patients/week. I'm in an area that is on the edge of rural but close to bigger cities. I have around 20-30 cancellations/month usually due to weather or farming/ranching reasons.
3) Private practice, OP, orthopedic.
4) Kentucky.

 

[wanderlustpt]

If I understand correctly - the clinic expects you to bill 4 codes for a 30-min treatment?

My clinic expects 4 codes for a 60 minute treatment. This applies to non-medicare patients only, as you are only able to bill for the 1-on-1 time you spent with your Medicare patient. My 60 minute treatments are not entirely 1-on-1...so billing 4 codes for a Medicare patient is just not possible - especially when following the "8 minute rule".

At my clinic patients are scheduled every 30 minutes, but the sessions overlap. For instance, my first patient arrives at 9am. My second patient arrives at 9:30am. As I'm starting with my second patient, my first patient is generally independently performing their therex. The cycle continues as patient #3 walks in at 10:00am and patient #1 is on their way out the door. I bounce back and forth between the two patients I am treating in order to make corrections to their form and add progressions as needed.

Hope that makes more sense.

Side note - the 4 codes per patient doesn't happen every time. As I add up the time I spend with each patient, there are some instances when I realize my patient didn't receive enough skilled PT to justify billing a 4th code (i.e. the patient received 10 minutes of pre-session heat and 10 minutes of post-session ice - taking 20 minutes away from their skilled PT session).

 

[starrsgirl]

Obviously, I'm not practicing yet, but that kind of pace and patient numbers make my head spin. And the billing seems to overlap in my mind too (whether or not they are Medicare). I came from the personal training world, and billed for a full hour and gave a full hour to the client. It's hard for me to think about spreading myself out between patients but still charging for it. In my mind, if they can do it at home, they should. If they can do it without me (heat or ice or warmup), they should and that should occur before or after our time together and I won't charge for that. I'm interested to hear more about this as I get close to choosing my area of practice...but it also makes me feel defeated about PT and the current practice.

 

[jblil]

Unfortunately, that seems to be the norm in many private OP clinics. The name of the game is to suck out as much $ as possible from Medicare and insurance companies.